Individual
MARIA T VAZQUEZ-PERTEJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3461 FAIRLANE FARMS RD, WELLINGTON, FL 33414-8752
(561) 766-1300
(561) 693-0539
Mailing address
3461 FAIRLANE FARMS RD, WELLINGTON, FL 33414-8752
(561) 766-1300
(561) 693-0539
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME0079884
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
258840400
—
FL
01
—
35281
BLUE CROSS BLUE SHIELD
FL
Enumeration date
02/03/2006
Last updated
02/19/2015
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